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South Carolina Primary Care Association Evaluation & Management Auditing Bootcamp
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12/6/2018 to 12/7/2018
When: Thursday, December 6, 2018
Day 1: 12:00pm - 4:30pm Day 2: 8:00am - 4:30pm
Where: Hilton Head Marriott Resort
One Hotel Circle
Hilton Head Island, South Carolina  29928
United States
Contact: William Feagan

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South Carolina Primary Care Association Evaluation & Management Auditing Bootcamp 




This interactive 2-day training is intended for healthcare practitioners, medical billers, coders, auditors, office managers and IT professionals involved with authoring clinical documentation, generating E&M progress notes, auditing professional physician service claims and maintaining a healthy revenue cycle. The primary course focus will emphasis documentation guidelines set forth by CMS for reporting Evaluation and Management services (E&M), as defined by CPT. The curriculum will provide attendees with a strong grasp of Evaluation and Management auditing, coding and documentation techniques.


The curriculum is designed to assist in development and mastery of the necessary skill set to successfully audit Evaluation and Management (E&M) services. This education and training has been designed to promote compliance and minimize the risk mitigation associated with post-payment review and 3rd party audit exposure.


Curriculum specifics will include:

The “Key Components” associated with E&M code selection

The differences between the CPT and CMS E&M documentation guidelines

Discuss the use of utilization benchmarks to target potential risk areas

Explain the differences between the 1995 and 1997 examination guidelines

Determining the complexity of medical decision making (MDM)

The importance to ‘link’ ICD-10-CM codes to E&M services

Risks associated with certain EHRs solutions (e.g, “wizards”)

Distinguishing “problem-oriented” from “preventive” E&M services

What to look for when modifiers are reported with E&M services (e.g., -25)

How to use a well-constructed audit template to conduct reviews

Key steps to present audit findings to providers successfully and non-confrontationally

Day 1 of the program primarily focuses on instruction and review of pertinent source documents (e.g., AMA’s 2018 CPT guidelines and CMS’ E&M Documentation Guidelines and some of the categories of E&M services located in CPT.


Day 2 of the program will be used to reinforce Day 1 learning objectives while focusing on specific categories of E&M service. There will be a series of hands-on cases for instructor-led audit instruction followed by individual or small group audits of cases presented by class attendees.


IMPORTANT! - For added value - bring your own notes for solo or small group review so you walk out with completed audits! Please be sure to remove any and all information that can identify the patient- this is known as being HIPAA de-identified.

Attendee Responsibilities:  Each attendee is expected to present to class with the following:


2018 CPT (AMA Professional Edition strongly encouraged)

Up to 5 HIPAA de-identified E&M cases for potential solo and/or group hands-on review

2 highlighters

A printed copy of the CMS Evaluation & Management Services Guidelines

A copy of any internal audit tools, templates, or score sheets currently being utilized by your facility

Day 1 Agenda

11:30 p.m. – 12:00 p.m Registration & Coffee, Tea, Water will be provided throughout the day

12:30 p.m. – 4:30 p.m.

Overview and CPT E&M Instructions

Defining time in the inpatient/outpatient settings

When to use CPT vs. CMS E&M Documentation  Guidelines

Preventive versus Problem-Oriented E&M Services

Documenting valid chief complaints

History of Present Illness and Review of Systems (HPI/ROS)

Day 2 Agenda

7:30 a.m. – 8:00 p.m Registration & Breakfast will be provided

8:00 a.m. – 12:30 p.m.

Review of all remaining CPT E&M categories

Reinforcement of “key” components, modifiers, and global surgical package considerations

Overview the ARHPC Audit Tool

Accurate completion of the E&M Audit tool

1:30 p.m. – 4:30 p.m. Lunch TBA


Past, Family, Social History (PFSH)


Hands-on Exercises and QA


1995 vs 1997 CMS Examination Guidelines


Geographic considerations (e.g., MAC Guidance)


Medical Decision Making and Medical Necessity


The role of EHRs and coding software in the auditing



Time based E&M coding


Putting It All Together using the “Key” components


Specific E&M categories of service



This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint providership of the University of Nevada, Reno School of Medicine and Association for Rural & Community Health Professional Coding.  The University of Nevada, Reno School of Medicine is accredited by the ACCME to provide continuing medical education to physicians.

The University of Nevada, Reno School of Medicine designates this live activity for a maximum of 10AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Exam Info:

After completing the 2 day bootcamp you will be given access to the optional 100 certification exam.  This will be emailed to each attendee approximately 1 week after the class date.


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